Cancer

Cancer Detecting Breathalysers Now on Clinical Trials

With 1 in 3 people having a chance to develop some form of cancer in their life according to the NHS, the development of a reliable and efficient diagnostic system is crucial for man kind’s fight against cancer.

The birth of this technology has been hailed as a revolutionary diagnostic system and is thought to save thousands of lives in the near future.

Early diagnosis of cancer has been proven to greatly increase survival rates.

Cancer Research UK states that when diagnosed at stage 1, lung cancer patients have a survival rate of about 30%, while ovarian and bowel cancer patients it is about 90%. When diagnosed at stage 4, all said cancer patients have a survival rate of less than 10%.

Recently, a new method of cancer diagnosis using breath tests is currently being studied as a tactic for early cancer diagnosis.

The science world has been exhilarated as the news of cancer-detecting breathalysers are said to be now on clinical trails. 

Why Cancer is So Hard to Cure

Cancer is a unique disease, caused by a genetic mutation in a cell making it divide uncontrollably. The diagnosis of the cancer would depend on which type it is, breast cancer is diagnosed with a mammography while colon cancer is diagnosed with colonoscopy. Picturing the numerous types of cancer that exist it is clear why cancer diagnosis is often delayed to the later stages.

Cancer also spreads (the technical term being metastatic). When a cancer is large enough it will find itself in a hypoxic environment (low oxygen levels). To continue to grow the cancer needs blood vessels to provide it with oxygen.

At this stage the cancer will send chemicals known as growth factors to promote angiogenesis (angio- blood vessel related, genesis- formation). Upon blood vessel formation the cancer will grow at a much faster rate and some of the cells may break off from the primary cancer and spread/metastasise through the blood vessels.

To make things difficult prior to angiogenesis a cancer can not grow larger than a pinhead, meaning that once symptoms have occurred the cancer is already metastatic and growing rapidly.

Metastasis also provides another obstacle for treatment. The type of cancer is termed from the primary cancer regardless of location. If a primary lung cancer has metastasised to the brain, the secondary cancer is not brain cancer, it is a lung cancer that has metastasised to the brain.

Afterall, the cell is still a lung cell, it is just located in the brain. This is important as when giving therapies the doctor must use therapeutics specific to the primary cancer.

The current available treatments are chemotherapy and radiotherapy. The side effects of treatment depend on the stage of the cancer, cancer treatment often has severe side effects as it is difficult to target.  

A cancer cell is not foreign, it is still recognised as a body cell, the only difference being a modification in genes related to cell division. Thus, side effects of treatment often include destruction of healthy cells in the process.

The Birth of Cancer Diagnosing Breathalysers

Cancer

In the past 10 years, Hossam Haick of the Israel Institute of Technology developed a breathalyser that can distinguish at least 17 types of cancer using a breath test.

The birth of this technology has been hailed as a revolutionary diagnostic system and is thought to save thousands of lives in the near future.

The breathalyser works by using an antenna created with gold nanoparticles to assess volatile organic compounds (VOCs) exhaled by the patient.

Cancer cells secrete metabolic products into the bloodstream which move to the lungs via gas exchange in the alveoli. The VOCs exhaled are dependent on which cancer type, essentially creating a cancer “fingerprint” allowing researchers to distinguish different types of cancers depending on VOC levels.

The team measured breaths from over 1400 patients and found the breathalysers to be accurate 9 in 10 times. From this study, they found that there are at least 13 different compounds that change in concentration with different cancer types.

Clinical Trials

In January 2019, Cancer Research UK announced they have started clinical trials in a hospital in Cambridge, alongside Owlstone Medical who supplies the device.

The trial aims to recruit 1500 individuals both healthy and cancer patients over a span of 2 years. They will start with patients suffering from oesophageal and stomach cancers and will expand to prostate, kidney, bladder, liver and pancreatic cancers.

Rebecca Fitzgerald, lead researcher of the study, said that Owlstone Medical’s breath test is “the first to test multiple across multiple cancer types”.

Owlstone Medical is also starting phase II clinical trials on lung cancer diagnosis funded by the NHS.

Billy Boyle, co-founder and CEO of Owlstone Medical, studied the applications of FAIMS technology (High-Field Asymmetric Waveform Ion Mobility Spectrometry) in medicine after his wife died of cancer due to late diagnosis.

He says that the “concept of providing a whole-body snapshot in a completely non-invasive way is very powerful and could reduce harm by sparing patients from more invasive tests that they don’t need.”

Boyle’s invention is indeed one of a kind in cancer diagnosis, with current research it may not be as accurate as individual diagnostic techniques but as it is a non-invasive, inexpensive, quick and most importantly universal form of diagnosis it is no question why the breathalysers are praised as the pioneer of early cancer detection.

Paving The Path For Breath Biopsies

Cancer

It turns out that breath tests have been used long before the creation of the breathalysers, trained dogs can detect lung cancer in a person’s breath.

Another example would be from an elderly woman named Joy Milne who found that her husband smelled differently suddenly and took him to the hospital where it was found that the husband has Parkinson’s disease and luckily due to Joy’s nose the diagnosis was done far before the effects took place.

She admitted that she often smelled the smell on strangers as well. She was then called by researchers for an experiment where she was accurate to 98%, she also correctly re-diagnosed a patient as healthy having previously being misdiagnosed with Parkinson’s.

With the rise of the breathalysers there is now a quantifiable way to understand the VOC changes in specific diseases. The ability of the breathalysers is being studied of its full potential.

Outside of cancer, Owlstone Medical are also studying breath biopsies in diagnosing infectious and inflammatory diseases. In Israel, Hosam Haick is further researching the accuracy of breath biopsies in diagnosing Parkinson’s.

However, there are some other variables that influence the effectiveness of the breathalysers. Public education as an example is crucial.

It is pointless to have a state-of-the-art diagnostic system if people do not go to their regular medical check-ups to be diagnosed. Also, some do not wish to take tests in the first place in fear of the results.

Nonetheless, as a non-invasive and early diagnosis method is highly demanded, it is certainly a possibility that these cancer detecting breathalysers will reach hospitals worldwide and hopefully aid humanity against arguably its toughest medical obstacle.